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The Ethics of Eugenics: Exploring Buck v. Bell

By Leah Tharakan

Edited by Bella Tran, Jia Lin, and Colin Crawford

The case of Buck v. Bell, which upheld the constitutionality of forced sterilization for individuals deemed “unfit,” was a landmark decision for the American eugenics movement and stands as a stark reminder of the tumultuous ethical landscape surrounding the application of eugenics in the early twentieth century. The eugenics movement is a theory which alleges that it is possible to perfect people through genetics and the scientific laws of inheritance [1]. It claims that hereditary defects weaken society, and should therefore be eliminated. Francis Galton, cousin of the father of evolution, Charles Darwin, believed that eugenics could control human evolution and development. The eugenics movement claimed that certain unwanted traits such as “feeble-mindedness, physical disability, and even poverty could be controlled through selective breeding. Proponents argued that these traits could be inherited and would weaken society through inferior offspring in the following generations. 

The approval of eugenics during this time is evident in the compulsory sterilization movement which became influential in politics and the U.S. court system, as apparent in the case of 17-year-old Carrie Buck. Buck, described as a “feeble-minded woman,” was subjected to forced sterilization as a result of societal influences rejecting individuals who were characterized to have any undiagnosed mental illness [2]. Carrie’s sterilization perpetuated implications that reverberated far beyond the court’s chambers and into an applicable modern context. The case, decided on May 2, 1927, in an 8-1 decision by the U.S. Supreme Court ordered that Buck be sterilized under the Virginia Eugenical Sterilization Act of 1924. Buck v. Bell ignited relentless ethical discourse, challenging the modern foundations of disability ethics and human rights– the effects of which are still evident in today’s modern context– through the due process clause of the Fourteenth Amendment.

I. Case Details

Carrie’s story began when she became pregnant with her daughter, Vivian, after being assaulted. After realizing that Carrie was with child after being raped, Carrie’s foster parents abandoned and sent Carrie to the Virginia State Colony for Epileptics and Feebleminded, where Carrie’s biological mother, Emma, was institutionalized. Emma and Carrie were both deemed to be feebleminded and promiscuous due to their children being born out of wedlock. A pregnancy out of wedlock was considered to be one of the “eugenic symptoms of inherent immortality” to the doctors at the Colony [3]. It was also here, at the Colony, where Carrie would become the center of a legal battle that would shape the course of eugenics in the United States for years to come. According to medical professionals at the Colony, Carrie’s condition had been present in her family for the last three generations, and therefore encouraged Carrie’s sterilization. The mentality amongst professionals at the Colony was: “like produced like,” and that by sterilizing all the unfit members in Carrie’s bloodline, others would not be tainted with the impurities of being feebleminded [4]. The Virginia Eugenical Sterilization Act was signed into law on March 20, 1924, and stated that an inmate with institution’s board approval, could be sterilized if they were found to be feebleminded. Medical professionals at the Colony alongside the defendant, the superintendent of the State Colony for Epileptics and Feeble Minded, were ordered to perform the sterilization, a salpingectomy (removal of one or both fallopian tubes) using the Act to justify the sterilization. 

Once Virginia’s Eugenical Sterilization Act was in motion, Carrie was one of the first to be selected to promote the “health of the patient and the welfare of society,” as the act claimed [2]. From its inception, Carrie’s case was a losing battle. Her legal representation had close relations with the staff of the Colony, so her lawyer sided with the opinion of the Colony which resulted  in inadequate representation. With her case reaching the U.S. Supreme Court, the judiciary's decision to uphold her forced sterilization under the 1924 Act, set a precedent that emboldened the eugenics movement's influence in American society. Justice Oliver Wendell Holmes, Jr., voting in favor of eugenics, emphasized that Carrie Buck’s challenge to their ruling did not pertain to the medical procedure itself but rather to the process of the substantive law. In the case of Buck v. Bell, the due process clause in the Fourteenth Amendment was invoked and analyzed by the U.S. Supreme Court, stating that no state shall “deprive any person of life, liberty, or property, without due process of law.” The Court, taking into account “months of observation,” deemed the operation permissible, thus justifying its stance that no Constitutional violation had occurred. Justice Holmes’ now-infamous phrase, “Three generations of imbeciles are enough,” epitomized the eugenic mindset that the state must intervene in order to protect the perceived genetic integrity of society. 

The ruling, delivered on May 2, 1927, underscored the judiciary's readiness to sanction coercive eugenic practices, raising concerns about the legitimacy of disability ethics and human rights in the United States. Furthermore, the Court’s decision set a precedent that allowed state governments to encroach upon individual reproductive rights under the guise of protecting collective welfare, despite the due process clause’s intended purpose of safeguarding individuals from repressive government intrusion. Carrie’s case stands as an example of the limitations of interpretations of the due process clause in the context of state-imposed eugenic practices during the early twentieth century.

II. Current Context

In the wake of the Buck v. Bell 's decision, the American eugenics movement gained substantial momentum, with the case serving as a landmark legal validation for the implementation of eugenic policies across the United States. Despite being over a century removed from the decision, its ramifications continue to reverberate in contemporary society. The legacy of eugenics, tainted by the injustices inflicted upon Carrie Buck and countless others, persists in the modern era, manifesting in the bolstered authority of state governments enforcing compulsory sterilization laws. These laws are responsible for  the involuntary sterilization of over sixty thousand individuals in over thirty states, the last known mandated sterilization being in the late 1970s [5]. The practices authorized by the Buck v. Bell ruling continued unabated for decades, altering the lives of countless individuals who were subjected to state-mandated sterilization, often without informed consent. 

While Carrie’s case marked the initial instance of forced sterilization under Virginia’s Eugenical Sterilization Act, the repercussions of the decision extended beyond her individual experience. In the state of Virginia alone, roughly 8,300 individuals underwent involuntary sterilization before the repeal of the act in 1974 and the nationwide cessation of related practices in the 1970s [6]. It was too late, however. The precedent set by Buck v. Bell– which reestablished and reinforced existing social stigmas– continued to permeate society. Until 2012, the initial justifications established in the Buck v. Bell ruling, particularly regarding the sterilization of individuals deemed “feebleminded,” had not been explicitly overturned, concerns on the resurfacing of the dangerous ideas presented in Buck v. Bell arose. In future debates on reproductive rights and the limits of state intervention within the bounds of the Fourteenth Amendment, the question of balancing individual autonomy and the potential for state-mandated interventions in the name of eugenics remained a haunting thought.

In the years following Carrie’s case, other states began to question the topic of eugenics, a subsequent case being Skinner v. Oklahoma (1942), which challenged the constitutionality of Oklahoma’s sterilization law and marked a pivotal turning point in the legal interpretation of eugenic practices [7]. The Supreme Court’s decision in Skinner v. Oklahoma highlighted the necessity of administering increased judicial scrutiny to laws involving sterilization, emphasizing the importance of protecting the fundamental rights and liberties of individuals, thus shaping the contemporary interpretation of the due process clause within the Fourteenth Amendment. 

III. Conclusion

The enduring legacy of Buck v. Bell, entwined with the dark history of the American eugenics movement, serves as an important reminder of the profound ethical complexities inherent in the intersection of individual rights and collective good under the law. As evidenced by the staggering number of individuals affected by involuntary sterilization, the repercussions of Buck v. Bell extended well beyond the confines of the courtroom, leaving a permanent mark on the lives of many who were subjugated to state-sanctioned eugenic practices. The Court’s interpretation of the due process clause within the Fourteenth Amendment favored the “collective” welfare of U.S. citizens over bodily autonomy, resulting in the continued bias surrounding the mentally-ill and disabled communities. Moreover, the subsequent legal milestone of Skinner v. Oklahoma in 1942 reflected a growing judicial recognition of the need to uphold the principles enshrined in the due process clause of the Fourteenth Amendment, safeguarding individuals from unwarranted state intervention in matters of personal autonomy and reproductive rights. This shift in judicial perspective, marked by a more robust commitment to the protection of individual liberties, stood in stark contrast to the permissive stance perpetuated by the Buck v. Bell decision, signaling a crucial evolution in the interpretation of the due process clause within the context of state-imposed eugenic practices.


[1] Eugenics: Its Origin and Development (1883 - Present), National Human Genome Research Institute, 

[3] Alexandra Fair, The Sterilization of Carrie Buck | Origins, The Ohio State University (2022), 

[4] Carrie Buck & The Lynchburg State Colony, Kennedy Institute of Ethics, 

[5] Cynthia Prather et al., Racism, African American Women, and Their Sexual and Reproductive Health: A Review of Historical and Contemporary Evidence and Implications for Health Equity, 2 Health Equity 249 (2018).

[6] Nathalie Antonios & Christina Raup, Buck v. Bell (1927) | Embryo Project Encyclopedia, Arizona State University (2012), 

[7] The Right to Self-Determination: Freedom from Involuntary Sterilization, Disability Justice, 

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